Assessment of the pathologic inclusion criteria from contemporary adjuvant clinical trials for predicting disease progression after nephrectomy for renal cell carcinoma
Assessment of the pathologic inclusion criteria from contemporary adjuvant clinical trials for predicting disease progression after nephrectomy for renal cell carcinoma
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DOI：
10.1002/cncr.26695
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发表时间：
2012-09-15
期刊：
影响因子：
6.2
通讯作者：
Leibovich, Bradley C.
中科院分区：
文献类型：
--
作者：
Kim, Simon P.;Crispen, Paul L.;Leibovich, Bradley C.
背景：本研究的目的是评估所有当代佐剂试验中的病理纳入标准在预测肾细胞癌(RCC)疾病进展(DP)方面的准确性。方法：对1990-2001年间梅奥诊所(罗切斯特，明尼苏达州)收治的1363例M0肾细胞癌患者进行回顾性分析。我们回顾了临床病理特征，以确定是否有资格参加以下试验：ARISER、ASSURE、珠峰、PROTECT、SORCE和S-TRAC。DP定义为术后局部复发或远处转移。通过c(一致性)指数评估每个试验纳入标准准确预测DP的能力。结果：从梅奥临床队列中，我们确定分别有41%、45%、45%、33%、47%和23%的患者有资格参加ARISERS、ASSURE、EVEREST、PROTECT、SORCE和S-TRAC临床试验。总体而言，23%的患者经历了DP(n=317)。在符合条件的患者中，53%、44%、44%、57%、43%和59%在随访期间发生DP，10%、6%、6%、13%、6%和18%进入DP，但不符合ARISERS、ASSURE、珠穆朗玛峰、PROTECT、SORCE和S-TRAC试验的条件。根据ARISER、ASSURE、EVEREST、PROTECT、SORCE和S-TRAC的病理纳入标准预测DP的C指数分别为0.751、0.751、0.751、0.742、0.745和0.691。结论：虽然当代佐剂试验的病理纳入标准有显著差异，但所有6个佐剂试验均显示出较高的DP预测准确性。总体而言，纳入佐剂试验的患者中有43%至59%将发展为DP，而被排除在试验之外的患者中有6%至18%将在随访期间发展为DP。癌症2012年。(C)2012年美国癌症协会。
BACKGROUND: The objective of this study was to evaluate the accuracy of the pathologic inclusion criteria from all contemporary adjuvant trials in predicting disease progression (DP) for renal cell carcinoma (RCC). METHODS: A retrospective review was conducted on 1363 patients treated surgically for M0 RCC at the Mayo Clinic (Rochester, MN), from 1990 to 2001. Clinicopathologic features were reviewed to determine eligibility for the following trials: ARISER, ASSURE, EVEREST, PROTECT, SORCE, and S-TRAC. DP was defined as local recurrence or distant metastasis after surgery. The ability of each trial's inclusion criteria to accurately predict DP was evaluated by the c (concordance) index. RESULTS: From the Mayo Clinic cohort, we determined that 41%, 45%, 45%, 33%, 47%, and 23% of the patients would have been eligible for the ARISER, ASSURE, EVEREST, PROTECT, SORCE, and S-TRAC clinical trials, respectively. Overall, 23% of all patients experienced DP (n = 317). Among eligible patients, 53%, 44%, 44%, 57%, 43%, and 59% developed DP during follow-up and 10%, 6%, 6%, 13%, 6%, and 18% went onto DP while not being eligible for the ARISER, ASSURE, EVEREST, PROTECT, SORCE, and S-TRAC trials, respectively. The c index of each trial to accurately predict DP from the pathologic inclusion criteria of ARISER, ASSURE, EVEREST, PROTECT, SORCE, and S-TRAC were 0.751, 0.751, 0.751, 0.742, 0.745, and 0.691, respectively. CONCLUSIONS: Although the pathologic inclusion criteria of contemporary adjuvant trials have notable differences, all 6 adjuvant trials demonstrated high predictive accuracy of DP. Overall, 43% to 59% of patients included for the adjuvant trials would develop DP, whereas 6% to 18% of patients excluded from the trials would develop DP during follow-up. Cancer 2012. (c) 2012 American Cancer Society.